Toxin- and Drug-Induced Pathologies

  • Reinhard B. Dettmeyer


Numerous toxins can cause histopathological findings, some of which are considered highly characteristic for the ingestion of a particular toxin. Alongside the wide spectrum of drug reactions, including drug-induced fatal myocarditis (e.g., following diclofenac or clozapine use), ethylene glycol poisoning accompanied by the development of oxalate nephropathy and fungal poisoning involving massive hepatic necrosis are also worthy of note here. Antibiotic-induced pseudomembranous colitis and toxic epidermal necrolysis (Lyell’s syndrome) can also be mentioned here. Although anabolic steroid abuse may cause less specific histopathological findings, when taken together, these are nevertheless useful in terms of expert opinions. Allergic drug reactions may result in unspecific findings that can only be interpreted in conjunction with the detection of a particular drug. The same applies to microscopy findings in colchicine intoxication. In individual cases, drug intolerance may trigger anaphylactic shock. Although histological findings following the ingestion of heavy metals have been described in the literature, these are rarely seen in routine practice. Rarer intoxications are seen in conjunction with suicides, e.g., using English yew (Taxus baccata) or tobacco. If substances of this kind have been ingested, the microscopic examination of gastric contents can be extremely helpful.


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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Reinhard B. Dettmeyer
    • 1
  1. 1.University Hospital Giessen Institute of Forensic MedicineGiessenGermany

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